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ELC-13-1547Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL I Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 199953 Permit Number: ELC -7 -13 -1547 Scheduled Inspection Date: November 12, 2013 Permit Type: Electrical - Commercial Inspector: Devaney, Michael Owner: EDELMAN, ALEX Job Address: 9999 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Inspection Type. Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060134490 Contractor: MIAMI DADE ELECTRIC INC Phone: (305)685 -6429 comments POWER FUL FUTURE EQUIPMENT AND DATA OUTLET AND POWER OUTLET, EXISTING LIGHTS TO BE MOVED SWITCH TO ADEQUATE SPACE FOR NEW MEDICAL OFFICE INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP- 195029. Fire caulking. Demising walls to go all the way up to the deck. Failed" 00 f p Correction Needed ❑ �'° Re-Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. � G S November 08, 2013 For Inspections please call: (305)762 -4949 Page 14 of 37 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PRONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: Electrical FBC 20 JUL 10 2463 13x:e� -�,mee Permit No. 1.3 —154-1 Master Permit No. JOB ADDRESS: 9�?9Y zz A///®� vz /-,- 3 //R City. Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: Value of Work for this Permit: $_ r 90(1 � Square/Linear Footage of Work: Type of Work: ❑Address 16cration ONew ORepair/Replace Description of Work: &Alpr X / A.,J �. r'1�OT. 1s�sf lie u% /, ;d 1c Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ DDemolition 4 ?®w&s Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip zip. Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a coraftlon to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subje to attac ent. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspectio4pi hich oc rs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ovg d an a reinspection fee will be charged. er or Agent The foregoing ins t was acknowledged before me this z q day of Ltti� 20 by lx �i © 1�►� - �-zs o is ersonall known me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission pire APPROVED BY 5:7,< Motuy Public State of Florida Expires 04/031=5 ,--, e, / r Signature Contractor The foregoing instrument was acknowledged before me this day of 2d , b yD l%Ar'A— (IZ Z,6A- who is personally known to me or who has produced as identification and who did take an oath. NIBS NOTARY PUBLIC. A Structural Review (Revised 3 /12/2012)(Revised 07 /10 107XRevised 06 /10/2009)(Revised 3/15/09) sign: Print: My Commission Expires:, ...• Zoning Clerk s kl i Shoreview Center Miami Shores Village Building Department 10050 NE 2nd Ave. Miami Shores, Florida 33138 Florida 33138 Re: Remodeling Authorization. To Whom It May Concern: As the management company in charge of Shoreview Center (9999 NE 2nd Ave., Miami Shores, FL. 33138), I hereby authorize Rafael Trueba of Miami Dade Electric, Inc. to remodel the interior of (Suite 311 -A) to the desired specifications. If there are any questions or concerns, please feel free to contact us directly at 305- 756 -7747. Thank you in advance for your attention on this matter. f iter 9999 NE 2nd. Avenue, star. 305 Miami Shores, FL 33138 Tel. (305) 756 -7747 — Fax (305) 756 -7745 • i Shoreview Center Wednesday, July 03, 2013 TO WHOM IT MAY CONCERN: Please be advised that Julio Martinez is authorized to represent me in all matters related to the property located at 9999 NE 2nd Avenue, Miami Shores Village, FL 33138 as regards to permits and licensure in the village of Miami Shores. Building Owner Sworn and Subscribed before me on this 3 day of Jam, 2013 by Julio Martinez Who is personally known to me? otary Public State of Florida moo. ;:;��� MAMA TMSA( p * * MY COMMISSION # EE 091881 EXPIRES: May 9, 2015 �r° "*,f Fly` BMW itniBudget sr" 9999 NE 2". ,avenue, Ste. 305 Miami Shoves, FL 33138 Tel. (305) 756 -7747 — Fax (305) 756 -7745 1% Municipal, Contractor's Tax Receipt Miami —Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY CC N0: '000011539 BUSINESS NAMEMOCATION MIAMI DADE ELECTRIC INC 9021 SW 142 AVE 1623 MIAMI, FL 33186 RECEIPT NO. EXPIRES NEW BUSINESS SEPTEMBER 30, 2013 7434423 Must be displayed at place of business Pursuanttg- Cganty Code Sec 10 -24 OWNER TYPE OF BUSINESS MIAMI DADE ELECTRIC INC ELECTRICAL CONTRACTOR Restricted to City of Miami Shores H For more information, visit,,, miamidade govkazcollector HAD Local Business Tax Receipt Miami —Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY 726555 BUSINESS NAME /LOCATION MIAMI DADE ELECTRIC INC 9021 SW 142 AVE 1623 MIAMI, FL 33186 OWNER MIAMI DADE ELECTRIC INC PAYMENT RECEIVED BY TAX COLLECTOR 18.75 07/09/2013 0223 -13- 000579 LBT RECEIPT NO. EXPIRES RENEWAL SEPTEMBER 30, 2014 726555 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 SEC. TYPE OF BUSINESS PAYMENT RECEIVED 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR 75.00 07/08/2013 00001 1539 0223 -13 -000559 Ll ke iami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Faz: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: BUILDING Tb JUL 10 203 ��O [J E39P9 @gop9f?oppgoo�ou FBC 20 Permit No.M J � - -� Master Permit No ROOFING JOB ADDRESS: cR ci Ci N E- A A�k- rxn City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NQ Flood Zone: OWNER: N (Fee Simple Titleholder)- , ' l �� 9 City: Z�✓f� rTU�4. State: Tenant/Lessee ° ame_ _✓� Email: 3 / e /i—) �"✓!� �rS� ®s>�% /fi CONTRACTOR: Company Name: Address: City: Quali IVA it v MW I , State Certification or ReLyistration #: of Competency #: Contact Phone# I () Email Address: _ e DESIGNER: W'!L Phon Value of Work for this Permit: $quare/Linear Footage of Work: Type of Work: DAddition Alteration ONew ORepair/Replace ODemolition Color thru tile: Submittal Fee Scanning Fee $ Notary Permit Fee $ CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Traiuing/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, BEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant.' As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good Jaith Jai that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subj ct attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first insp lion whit occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will no b p ov anpl a r�inspeciion fee will be charged. Signature AV weer or Agent The foregoin nt was �ged vore i this day of , 20 ny l who is personally known to me or who has produced As identification and who did take an oath. Signature \� Contractor The foregoing instrument was acknowledged before e this day of I� .20 & by who is personally known to me or who has produced ...� as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: s,� ;::;�% YISEI.GARCIA WCAMMISSIN # EE 834979 * * EXPIRES: September 113, 2016 �r'9�OFRLO��� BaidedTfRUBudgetlJat�YS Sign: Sign: CC Print' Print: My Commission Expires: Kelly E. Gale My Commission Expires: vi l3 1y Commission #DD931513 Expires; NOV. 21, 2013 8oxp�n Tmtu ATtnrrric aoxnmraco.,>xu APPROVED BYr"%s%�L����1 Plans Examiner Zoning Structural Review Clerk (Revised 3 /1212012)(Revised 07 /10 /07)(Revised 06/1o12009)(Revissd 3/15/09) Shoreview Center Shoreview Center. 9999 NE 2nd Ave. Suite #305 Miami Shores, FL. 33138 -2346 Thursday, July 11, 2013 Miami Shores Village Building Department 10050 NE 2nd Ave. Miami Shores, Florida 33138 -2346 Re: Remodeling Authorization. To Whom It May Concern: As the management company in charge of Shoreview Center (9999 NE 2nd Ave., Miami Shores, FL. 33138), I hereby authorize Bruno E Ramos of Art Design & Construction, Inc. to remodel the interior of (Suite 311 -A) to the desired specifications. If there are any questions or concerns, please feel free to contact us directly at 305- 756 -7747. Thank you in advance for your attention on this matter. Respectfully, J. ine z S w A j Cen ter �% JM/bg 9999 NF 2 "'.Avenue, Ste. 305 Miami Shores, FL 33138 Tel. (305) 756 -7747 — Fax (305) 756 -7745 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. PY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ■ rrrrrarrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr� BUSINESS NAME: BUSINESS ADDRE STATE r—L ZIP CODE 65I BUSINESS PHONE: +P i "',-15� FAX NUMBER CELL PHONE . P I - !11 7A QUALIFIER'S NAME: NQnQ QUALIFIER'S LIC NUMBER: CQ (2.0 .�'i q E -MAIL ADDRESS OF APPLICABLE): Creatt1 on 3!79109 BY MLDV I RV 3i2M MI DV DBPR - RAMOS, BRUNO E; Doing Business As: ART DESIGN & CONSTRUCTION I... Page 1 of 1 Licensee Details Name: RANI AKT' Main Address: 3071. MIA' County: DAD Ucense Maiiing: Ucensetowtian: MIA County -, DA Construction Business 02/20/2004 View Related License Information View License Complaint 1940 North Monroe Street. Tallahassee 1.132399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer. Convrioht 2007 -2010 State of Florida. Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public- records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275 (1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. Please see our Charter 45,E page to determine if you are affected by this change. https:// www. myfloricWicense .comALicenseDetail. asp ?SID= &id= 93492D368A62FE57A86... 7/10/2013 FIRST -CLASS U.S. POSTAGE � PAID NHAW PL. PERMIT N0. 281 THIS IS NOT BILL — DO NOT PAY 215724 -6 EWAL BUSINESS NAME / LOCATION ��� 226932-2 ART DESIGN & CONSTRUCTION INC STATE& C00033989' 3075 NW S RIVER DR 33142 UNIN DADE COUNTY OWNER A�R,yT�DDEBSSIIGN & CONSTRUCTION INC ness Sec. BUILDING CONTRACTOR PAYNRNT lt.0[INTY TAX CO 04/06/2012 60040000040 000075.00 SEE OTHER SIDE WORKER /S DO NOT FORWARD ART DESIGN & CONSTRUCTION INC 3075 NW S RIVER DR MIAMI FL 33142 BEAAR -1 OP ID: S3 CERTIFICATE OF LIABILITY INSURANCE DAT0E ^ 71110/10113 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAT16N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED, the pol(cy(les) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Celed(nas Ins. Gp: Miami 1441 Brickell Ave Ste 1400 Miami, FL 33131 Marivel Andreu COMACT PHONE F ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC d INSURER A: The Hartford Insurance Co. 19882 INSURED BEA Architects, Inc. 3075 NW South River Dr Miami, FL 33142 INSURER 13: 08/26112 INSURER C: EACH OCCURRENCE INSURER D: PREMISES Ea occurrence INSURER E: MED EXP (Any one person) INSURER F : PERSONAL & ADV INJURY COVERAGES CERTIFICATE INUMRFR! REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IL SR TYPE OF INSURANCE AWL I SUER POLICY NUMBER POLICY E1tP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE I OCCUR 21SBMBT7561 08/26112 08/26113 EACH OCCURRENCE $ 1,000,0 PREMISES Ea occurrence $ 1,000, MED EXP (Any one person) $ 10,0 PERSONAL & ADV INJURY $ 1,000,0 GENERAL AGGREGATE $ 2,000,0 GEN'L AGGREGATE LIMIT APPLIES PER: X I POLICY W F I Loc PRODUCTS - COMP /OP AGO $ 2,000,0 $ AUTOMOBILE LIABILITY ANY AUTO ALL ED LED AUTOS AUTOS HIRED AUTOS AUTOS N/A a IINdED 'SINGLE LIMIT BODILY INJURY (Per person) $ BO LY INJURY (Per accident) $ OPE TY GE ease $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE N/A EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ WORI(ERSCOMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) if yes describe under DESCRIPTION OF OP RATIONS below NIA N/A ASUTAMTU O R E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ I E.L. DISEASE - POLICY LIMIT $ N/A DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, AddIItlonai Remarks Schedule, B more space Ia rewired) CERTIFICATE HOLDER CANCELLATION ®1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2nd Ave AUnfORUM REPRESENTATIVE Miami Shores, FL 33138 ®1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD CFN 2013RO573386 OR 9k 28734 Ps 2153't 0W ­noncn 0712212013 15:3'5-108 NOTICE OF COMMENCEMENT HARVEY RUVINt CLERK DF*CDURT A RECORDED COPY MUST BE POSE ONTH9.,SOB S TPP ON MIAMI70ADE COUNTYr FLORIDA " * 'E 7 L AST � ftf� F6 PERmrr NO. ;:.'�5VfAXk 0- I! STATE bFF*LbRIDA.:_*,,* COUNTY OF MIAMI-DARE: THE UNDERSIGNED hereby gives ' notice chat improvements will be made, to certain real proper* and in abcoidift-le i�'A bheip"W74 ' '046tid" a Statutes, 'the following, Information Is provided In this Notice of Commencement. d for u" of recording opaceebm Met." ofte Z .4 Ve-, 541"'�c 1 Legal description of property and strset/ad ress: lvhF 33 2. Desc of Improv.4 !me 7 t: / r 6 3. Owne" name and r'gze e_ Interest Iq property: Name and address :of fee simple titleholder: 4. C tr t e� :address and -phone number .07/' *Qlt' 7 AM! 0_7M WM., z 5. Surety:'(Payment -&n8 required by owner from contractor, if any) Name, e0dress and-phone number.. Amount of bond 6. Lender's name, and address: 7. P6r:i*q_ns within the State of Florida designated by Owner upon whom notices or other documents may be served es provided by ,,Florida Statutes, Name add and number 8. In addition to himself; 0 miers des 19 nates The following person(s) to receive copy of . the LlenGr's Notice as provided In Section 713.13(1)(b), Florida statutes. Name, address and phone 9. EitOlnitlbh -date of Notice of commencementz. Pe e*hvton dite Is 1 jim► from the dati of record" u*W a d'Iffemnt dWe Is specMeo T ®O E": MADE BY THE OWNERAFTER THE EXPIRAI. PNCIIFT�IE NOTICE OF COMMENCEMENT ARE CONSIDERED TER 713 YOUR PAYING TWICE FOR IMPROPER S UN, '-R =N 71313. FWAIDA'STAIlItES AND C 0 St BE RE D'POSTED IMPROVEMENTS T YO R, ERTY. A CE OF cbm!4ENCEMENT MU RECORDED CAN RESULT THE JOB SITE 13EPOIAE THE OR& iNiSPIE N I NO TO iNANCINd, CONSUIT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING ­ A E Fco=C N ENT. Signature(6) of or + eq d Officer/Director/Partner/Manager Prepared By Print Name Print Name Title/Officd Title /Office STATE 60 Fi_okim COUNTY OF m.iA"M-I­+DAD'E The oln st f7eptr Me this d C' + f ay of a! /Iowlidge,d before By PhdiMviduafly, or 1:1 as + for +. Personal d %l in or u Pers ioWn, Ification: gally prod 'ced the-,1oIIo"+'g�type,+qbIdent Signatr .re of.NqtatyPublic: Print, Name: MY C-OMMMDN#EE VF-RIF-IQMQN PURSUMT TO. SECTIO-k 92.Mi FLORIDA EXPIRES: May 9 - 20 FLIURI*j; ML Under *06haltles of p6jury, I declare that I have read the foregol W&*Sd�l heiq Of my 16 ) PjffC CERTIFY tha t this is a true COPY Of the C that the facts stated � In it are true, to the best knowledge mr, CURN + vrial I n;41 + m+ this o#6 on day of Signatur*) of Owner(s) or Owner(s)'s Authorized Ofter/Director/p + "Mho sIgn--e-d—a _Wwr- AD 20 N SS my_ 0f;YVEcSS my ,flan By ff .j Mff .aj SgW_ 123.01-52 PAW 3 Wo Miami -Dade County Building Department e- Permitting Search: m—"7 t?lI Status of Plans Process: M2013010773 Application Date: 07/2512013 Storage Location: By: Date Picked up: Page 1 of 1 Review Reviewed By Est Comp Date Dlsp Date Disposition DERM SYLVESTER, WILMA 07/25/2013 08/23/2013 A FIRE GONZALEZ, RICARDO 07/25/2013 08/15/2013 A PAYU FEE COL 07/25/2013 07/25/2013 EA �j HRS OMISCA, ERLANDE 07/31/2013 09/13/2013 Disposition Legend: A= Approved, D= Disapproved, N =N /A, P= Approved as Noted Page: 1 REVIEW STATUS INQUIRY SUCCESSFUL (NO MORE ENTRIES) BLDG Home Pane I BLDG Main Menu I BLDG Permit Menu I BLDG Plans Processing Menu I Inspection Types I Address Format E -mail your comments, questions and suggestions to Webmaster This page was last edited on: February 23, 2004 Web Site m 2004 Miami -Dade County. All rights reserved. http: / /egvsys.co.miami -dade. fl.us :1608/ W W WSERV /ggvt/BNZAW972.DIA ?KEY= M201... 9/13/2013 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 --V - Contractor • Owner • Architect Ad , r ,_ ,► From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: COUNTY APPROVED BY: DEPARTMENT OF REGULATORY & ECONOMIC RESOURCES LEE HEFTY, ASSISTANT DIRECTOR DATE: August 23, 2013 B & Z #: M2013010773 FOLIO #: 11- 3206 - 013 -4490 For the Director: Tomas Fonte, Eng NOTE: THIS APPROVAL IS NOT INTENDED TO COVER STRUCTURAL DESIGN. NO CONSTRUCTION SHALL TAKE PLACE ON tONTAMINATED GROUND. INDUSTRIAL FACILITIES SECTION ONLY PROJECT NAME: Medical Chiropractic Offices for Dr. Stein ADDRESS (APPROX.): 9999 NE 2 Avenue, Unit 311A Miami Shores, FL CONDITIONS: 1. This approval is granted for proposed medical chiropractic office with three (3) medical exam /treatment room, one (1) stock room, one (1) business office, one (1) waiting room, and x -ray room with locations as shown on plans. a. As per plans and information provided the facility will be utilizing digital x -ray technology (i.e., Direct View Vita 46 CR manufactured by Care Stream) with no wet processing and or development being conducted at this facility. b. Facilities operations will generate small amounts of bio- hazardous waste that will be properly disposed of. Disposal of this waste must be conducted by DRER licensed facility. 2. Any and all discharges to the septic tank system will be that of domestic use only. 3. Operations at this facility shall be conducted without any discharges to open ground or to the storm sewer system. Improvements: If at any time this facility is found to be performing inadequately, the owner shall provide the required corrections and /or additional equipment to operate in compliance with Chapter 24, Miami -Dade County Code. M2013010773 9999 NE 2 Avenue Page 1 of 2 I Approval is hereby granted for: Medical offices w digital xrays, as described above. PROVIDED: 1. Construction is completed according to approved plans. 2. There may be county, municipal, or other local regulations or restrictions to be complied 4 with by the owner prior to construction of the facilities represented by these plans. We recommend that appropriate local agencies be consulted before starting construction. 3. No construction shall take place on contaminated soil. If contamination is encountered during construction, contact the Pollution Remediation Section of the Department of Regulatory & Economic Resources (DRER). cc: Xiomara Lopez - DRER M2013010773 9999 NE 2 Avenue Page 2 of 2 NEW WALS O EXISTING WALLS Sheet E1 ►.�09 Power Plans Project Dr.Stein, 9999 NE 2 Ave, Miami Shores, FI Contractor: Miami Dade Eleclric w Dr's Office X -ray room B B B B Exam room B B e Exam room A Waiting Room Replace Pocket Door NEW WALS EXISTING WALLS N Sheet E2 lighting Plans Project Dr.Stein, 8998 NE 2 Ave, Miami Shores, Fl Contractor. Miami Dade Electric CO3 Main Sheet: E3 MDP sec 1 sec 2 Contractor: Miami Dade Electric is 200a 200a w 200a 3phase 3phase 3phase existing existing: existing Sheet: E3 Riser Plans Project Dr.Stein, 9999 NE 2 Ave, Miami Shores, Fl Contractor: Miami Dade Electric is w DERV Dr. stein 9,999 NE 2 Ave, Unit 311A Miami Shore, Fl. Process # M2013- 010773 Summary of remarks addressed 1. X-ray imaging equipment and if it uses chemicals a. The imager is a fully digital unit (NO chemicals) b. unit model: Care stream VITA 46 CR. c. Please see attached manufacture detail brochure 2. Waste a. All of the waste is placed in medical waste container. b. All medical waste is removed by license vendor c. Please see letter provided by doctor. 3. Use of space a. Orthopedic office b. Please see letter from doctor 4. Occupancy a. Office personnel 2 to 3 b. Patients average 8 c. Occupancy is noted on plans and doctors letter. Summary prepared by Rafael Trueba 305 -244 -7788 rtrueba @bellsouth.net JAY G. STEIN, M.D., P.A. DIPLOMATE, AMERICAN BOARD OF ORTHOPAEDIC SURGERY 209 N.E. 95TH STREET, SUITE a MIAMI SHORES, FLORIDA 33138 To Whom it may Concern: TELEPHONE (305) 751.2850 FAX (305) 751 -614B We are an Orthopedic Office. Each day Monday through Thursday, we see approximately 6 -10 patients for muscular skeletal complaints. We do X -ray using Digital processing on our patients when needed. Any medical waste rarely a dressing and/ or syringe, is place in a medical waste container and disposed of by a licensed provider. We do provide prescriptions for medications, limited physical therapy on site, and referrals for surgical patients. Our patients private or workman's compensation mo often have neck, low back, shoulder, and /or knee complaints. all M.D. r stre P, sic / %_� Vita CR Systems )"n ";g/-)-),- shO✓t: F/ -rh�c V, ;ft y6 w/11 be used. 3) loo D I ITAL. C O I\il PACT. /; a r�Ir" e S 6-n AFFORDABLE. .: . m{ Your commitment to your patients is immeasurable —but your budget and available space are limited. CARESTREAM DIRECTVIEW Vita CR Systems are the answer. They offer you compact, small- footprint solutions with high - quality digital images, all at a very affordable price. With three options for throughput speed, Vita CR Systems boost efficiency and productivity, while supporting quality patient care and better outcomes. With over 18,500 units sold throughout the world, Carestream is your trusted source for desktop CR systems. `a THE RIGHT SIZE. 17WE RIGHT SOLUTION. Why pay for capabilities you don't need and won't use? Many large, complex digital - imaging systems are overkill for your facility's applications. And, they carry a prohibitive price tag. Vita CR Systems provide- • Quality imaging at an affordable cost • The ability to offer in-house digital imaging • Faster turnaround time—for speedier diagnoses and enhanced care Boost Your Throughput and Productivity Vita C R Systems can really accelerate your workflow. Operator training and learning curves are both minimized, as our intuitive interface turns new users into experts in no time. Out "smart erase' feature optimizes erase time across all exposure levels. This improves operator productivity and reduces the cycle time between scans. Set Up and Start Scanning in Just Hours These systems save time and trouble at every step. Fast, easy setup means you'll unpack your system and be up and running the very same day! A small footprint allows simple installation, even in confined spaces. Preconfigured image-quality "looks" simplify selection and standardization of your default image preferences. (1.__HOOSE THE SPEED YOU NEED. All Vita CR System features and benefits are available in a model with just the right output speed for your facility: Vita LE CR System -20+ pph, Vita CR System-40+ pph, Vita XE CR System-60+ pph, (plates per hour based on standard 14 x 17 inch cassette) Cassette Pixel Matrix Pixels Per Throughput I Plates Per Hour W -5%) Size Size Millimeter Vita LE Vita XE S T A N DAR D R E S O L UT I ON 14 x 17 in. 2180 x 2660 6 23 44 63 2180 x 2180 6 27 46 66 11 x 14 in. 1700 x 2180 6 27 50 69 14 x-33 in. 2272 x 2748 6 11 23 30 H I G H R E S 0 L U T 1 0 N 14 x 17 In. 4048 x 4932 12 2q 31 42 14 x 14 in. 4048 x 4048 12 21 32 43 11 x 14 in. 3156 x 4048 12 23 38 48 10 x 12 in. 2868 x 3460 12 30 41 51 9 x 10 in. 2872 x 2280 12 28 41 53 24 x 30 cm x 2880 12 25 40 53 15x30cm ­12284 1760 x 3404 12 24 47 62 SMVW Procedures arw cut Your Costs ItIs time to say goodbye to the cost of purchasing film and storing chemicals. Vita CR systems, wide range of cassettes and phosphor screen sizes gives you everything you need. The systems are easy to service, loo—fewer Pam make maintenance a breeze and reduce service costs and downtime. Specialized Appikations For use beyond hospitals, dinia, and special practices, Vita CR systems feature a seated design, rugged construction, and resistance to temperature and humidity extremes. Light system weight and easy portability make these systems ideal for military and mobile use. SpQdality offices gain affordable in-house imaging, while a Dentat Panoramic package and Long-Length imaging meet the needs of specialty imaging. Total Quality Toot Option Perform objective image test and quality-control measurements with the Total Quality Tool Option: verify your equipment is functioning within normal operating specifications, then export the data to a spreadsheet application for analysis and record keeping. Long-Length imaging Option Vita CR Systems also offer an optional solution for long - length imaging (Lu). This easy-to-use accessory allows you to capture and process digital images of longer anatomical regions. It easily handles spinal exams, even those with images too large for a typical 14 x 17 inch screen. A portable caddy with embedded grid, and a wallstand with grid and beam-attenuatioh fitters are also available. Cu�Created Software Optimize the performance of your Vita CR System with the affordable Carestrearn Image Suite software package This acquisition and optional mini-PACS software delivers high-quality images while streamlining your image-management workflow. You'll increase your productivity and enhance care with this scalable solution. Compact Cart for Vita CR Systems This can features a compact design and easy mobility. It meets all medical standards and quality requirements, and accommodates any commonly used K. Options include, flexible configurations featuring additional cassette and PC holders. 0 2=50316-001111 1� I � � ffi� CARESTREAM CR Screens and Cassettes Ideal for use with the Vita CR Systems, our line of C R cassettes and phosphor screens offers a wide selection and high performance to meet the needs of various CR exams and clinical applications, including long-length imaging, orthopedics, pediatrics, and more. System Specifications PRODUCT DESCRIPTION The Vita CR systems use Carestrearn GP-2 Phosphor Screens and standard Vita CR System Software or optional Image Suite, Software. REQUIREMENTS Host PC with the following minimal configuration: Dual-Core Intel CPU 2 G RAM 80 GB HD CDx24 Windows XP SP3, Windows Vista Business SP2 (UAC disabled) Windows 7 DIMENSIONS 34 cm x 75 cm x 55cm / 29.5 in x 21.7 in x 13.4 in WEIGHT 36 kg / 79 lbs www.carestream.com/vita CCmh*eamHed6,kK,2012.CARMRFAM and DMfCrAEW are trademarks ofCamstmmHeahh. GAT 2000010 OM2 Whxb is a reoAwW badmwk of Whaosoft Corporafim hAd is a Uadenwk of InW Cowadm. standard Vita CR System Software FEATURES DICOM Send Local Short-term Archive Print Composition DICOM and Windows Print DICOM Viewer AVAILABLE OPTIONS Total Quality Too[ Long-Length Imaging CD/DVD Authoring Modality Worklist Dental Panoramic Package Optional Image Suite Software FEATURES Enhanced user interface for Acquisition Web Order Entry DICOM and HL7 Compliant DICOM Print Multi-format Printing DICOM Viewer AVAILABLE OPTIONS Mini-PACS Archiving Clinical Reporting Web Viewer License Long-Length Imaging DICOM Store Service Class Provider (SCP) Advanced Measurement T0015 Set